From the Guidelines
Lunesta (eszopiclone) is recommended as a treatment for sleep onset and sleep maintenance insomnia in adults, with a suggested dose of 2-3 mg, as stated in the American Academy of Sleep Medicine clinical practice guideline 1. The medication belongs to a class of drugs called sedative-hypnotics and works by affecting certain brain chemicals that may be unbalanced in people with sleep problems. Some key points to consider when prescribing Lunesta include:
- The typical starting dose is 1 mg taken right before bedtime, though some patients may require 2-3 mg 1.
- Lunesta should only be used for short periods (usually 7-10 days) as it can be habit-forming with longer use.
- Side effects may include unpleasant taste, drowsiness, dizziness, and morning grogginess.
- Patients should take Lunesta only when they have 7-8 hours available for sleep to avoid next-day impairment.
- It's essential not to consume alcohol while taking this medication as it can increase sedative effects.
- Those with liver problems, respiratory conditions, or a history of substance abuse should use Lunesta with caution.
- The medication works by enhancing the activity of GABA, an inhibitory neurotransmitter that reduces brain activity, helping to induce and maintain sleep. According to the American College of Physicians, cognitive behavioral therapy for insomnia (CBT-I) should be considered the first-line treatment for adults with chronic insomnia disorder, and pharmacological therapy, such as Lunesta, should only be added if CBT-I alone is unsuccessful 1.
From the FDA Drug Label
Eszopiclone tablets are sedative-hypnotic (sleep) medicines. Eszopiclone tablets are used in adults for the treatment of a sleep problem called insomnia. Symptoms of insomnia include: trouble falling asleep, waking up often during the night Eszopiclone tablets are not for children.
Lunesta (eszopiclone) is a sedative-hypnotic medication used to treat insomnia in adults. It is not intended for use in children. The medication works by interacting with GABA-receptor complexes to produce a hypnotic effect. Key points to consider when taking eszopiclone include:
- Take the medication exactly as prescribed
- Do not take more than the prescribed dose
- Take the medication right before bedtime
- Do not take the medication with or after a heavy meal
- Avoid taking the medication with other medications that can cause drowsiness
- Be aware of the potential for side effects, such as sleepiness during the day, confusion, and unusual behavior 2
From the Research
Overview of Lunesta
- Lunesta, also known as eszopiclone, is a nonbenzodiazepine hypnotic agent used to treat insomnia in adults 3, 4.
- It is approved in the US as an oral, once-nightly therapy for insomnia in adults and is also under review by the European Medicines Agency 3, 4.
Efficacy of Lunesta
- Studies have shown that eszopiclone significantly improves both sleep onset and sleep maintenance compared with placebo in adult and elderly patients with primary insomnia 3, 4, 5.
- Eszopiclone has also been shown to improve sleep parameters in patients with insomnia coexisting with other conditions that disturb sleep (co-morbid insomnia) 3, 4.
- A meta-analysis of 14 randomized controlled trials found that eszopiclone decreased sleep onset latency by 12 minutes and wake time after sleep onset by 17 minutes, and increased total sleep time by 28 minutes compared to placebo 5.
Safety and Tolerability of Lunesta
- Eszopiclone is generally well tolerated, with the main treatment-emergent side effects being unpleasant taste, headache, and dizziness 3, 4, 6.
- Adverse events that were documented more frequently under eszopiclone compared to placebo included unpleasant taste, dry mouth, somnolence, and dizziness 5.
- There was no evidence of tolerance during 12 months of treatment with eszopiclone, and no rebound insomnia or serious withdrawal effects were observed on discontinuation 3, 4.